Welcome to my blog. HIV prevalence is not a reliable indicator of sexual behavior because the virus is also transmitted through unsafe healthcare, unsafe cosmetic practices and various traditional practices. This is why many HIV interventions, most of which concentrate entirely on sexual behavior, have been so unsuccessful.

The cost of each circumcision will probably be about 25 times per capita spending on health by government and donors combined. The $150 million said to be spent on treating government officials abroad seems diminished beside what will be spent on a mass male circumcision program that, even according to enthusiasts, may only prevent one infection in every 100 men circumcised.

Perhaps we should not worry so much. There are plans to train people who are not surgeons, who are not even doctors, to carry out the bulk of the operations. But, rather than spending so much on what will effectively be a parallel health system, dedicated entirely to circumcising men, it might seem better to provide incentives for some of the tens of thousands of trained Ugandan health professionals currently working in the US to return to their home country for a while?

In fact, $500 million could do a lot for health in Uganda. Instead of blowing it on an operation that is more risky, more expensive and less effective in reducing HIV transmission than correct penile hygiene, many of the most common diseases that cause the highest proportion of morbidity and mortality could probably be cut to a fraction with that kind of money. So why the continued insistence on circumcision at all costs?

2 comments:

Good post. There are many of us who think that the populations of many parts of Africa are going to greatly diminish over the next generation. This is because HIV will increase from people thinking that circumcision protects against HIV and they refuse to wear a condom. HIV is passed through blood, semen, and vaginal fluid. So, circumcised or not, that HIV positive man still needs to wear a condom to prevent the disease from spreading. Any man who isn't HIV positive should also wear a condom, to protect himself in case his partner is.